New York Times, June 24, 2008: Tropical Diseases Add to Burden Among the Poor in U.S.

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Ailments of poverty, including some tropical diseases much more common in poor countries, are a burden in several regions of the United States, a new analysis finds.

The diseases affect thousands of the poor concentrated in the Mississippi Delta, Appalachia, the borderlands with Mexico, poor urban neighborhoods and tribal reservations, says the report, which appears this week in Neglected Tropical Diseases, a journal of the Public Library of Science. Many are insidious and disabling; some may be transmitted at birth.

That they are not higher on the public health agenda “is a national disgrace,” said the author, Dr. Peter J. Hotez, chairman of the tropical disease department at George Washington University.

The prevalent diseases include Chagas, spread by blood-sucking insects; cysticercosis, spread by tapeworm eggs in dirty drinking water; and worm diseases often spread through soil near houses where pets have not been dewormed, or in urban playgrounds.

Other potentially dangerous infections include dengue fever, spread by mosquitoes; syphilis, which is spread by sexual contact and which may be transmitted to infants; and cytomegalovirus, which is dangerous to an infant if a mother acquires it in pregnancy.

Immigrants from refugee camps in Africa or from Mexico and Central America often have high rates of worm infections or insect-borne diseases. Inuits in Alaska are susceptible to parasites carried in the meat of seals, polar bears and caribou.

Dr. Hotez recommended more surveys of such illnesses, particularly more newborn screening and more collection of fecal samples to check for worm diseases.

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